U.S. Patent: 6083203 - Endoscopic portal

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United States Patent	*6,083,203*
Yoon	July 4, 2000

Endoscopic portal

Abstract

An endoscopic portal includes a valve assembly disposed at an open proximal end of a sleeve or cannula providing access to an internal operative site, the valve assembly having a passage therethrough of variable size to engage surgical instruments passing therethrough in sealing relation to prevent flow or leakage of fluid through the valve assembly.

Inventors:	Yoon; InBae (2101 Highland Ridge Dr., Phoenix, MD 21131)
Appl. No.:	369240
Filed:	January 6, 1995

Current U.S. Class: 604/167.01; 604/248

Intern'l Class: A61B 017/32; A61B 019/00

Field of Search: 604/158,159,160,161,162,163,164,165,166,167,168,169,170,248,264

References Cited U.S. Patent Documents

1986484	Jan., 1935	Schlueter.
2898917	Aug., 1959	Wallace.
3044461	Jul., 1962	Murdock.
3313299	Apr., 1967	Spademan.
3329390	Jul., 1967	Hulsey.
3366363	Jan., 1968	Hogan et al.
3487837	Jan., 1970	Petersen.
3509883	May., 1970	Dibelius.
3565078	Feb., 1971	Vailliancourt.
3585996	Jun., 1971	Reynolds et al.
3598118	Aug., 1971	Warren.
3620500	Nov., 1971	Santomieri.
3703899	Nov., 1972	Calinog.
3747812	Jul., 1973	Karman et al.	222/387.
3766916	Oct., 1973	Moorehead et al.	604/167.
3788318	Jan., 1974	Kim et al.
3789852	Feb., 1974	Kim et al.
3833003	Sep., 1974	Taricco.
3853127	Dec., 1974	Spademan.
3895632	Jul., 1975	Plowiecki.
3970089	Jul., 1976	Saice.
3977400	Aug., 1976	Moorehead.
3994287	Nov., 1976	Turp et al.
4000739	Jan., 1977	Stevens.
4096860	Jun., 1978	McLaughlin.
4112932	Sep., 1978	Chuilli	128/3.
4126133	Nov., 1978	Schwartz	128/214.
4177814	Dec., 1979	Knepshield et al.
4180068	Dec., 1979	Jacobsen et al.
4187849	Feb., 1980	Stim.
4233982	Nov., 1980	Bauer et al.
4234410	Nov., 1980	Graham et al.	606/185.
4240411	Dec., 1980	Hosono.
4243034	Jan., 1981	Brandt.
4261357	Apr., 1981	Kontos.
4338689	Jul., 1982	Zieg	4/378.
4338934	Jul., 1982	Spademan.
4354491	Oct., 1982	Marbry.
4379458	Apr., 1983	Bauer et al.	604/264.
4387879	Jun., 1983	Tanachinski	251/149.
4424833	Jan., 1984	Spector et al.	137/849.
4430081	Feb., 1984	Timmermans	604/256.
4447237	May., 1984	Frisch et al.	604/175.
4464178	Aug., 1984	Dalton	604/174.
4475548	Oct., 1984	Muto	604/167.
4512766	Apr., 1985	Vailancourt	604/169.
4524770	Jun., 1985	Orandi	604/160.
4531937	Jul., 1985	Yates	604/53.
4535773	Aug., 1985	Yoon	604/51.
4540411	Sep., 1985	Bodicky	604/169.
4553760	Nov., 1985	Reed et al.	277/12.
4580573	Apr., 1986	Quinn	128/657.
4581019	Apr., 1986	Curelaru et al.	604/164.
4601710	Jul., 1986	Moll	604/165.
4610665	Sep., 1986	Matsumoto et al.	604/167.
4610674	Sep., 1986	Suzuki et al.	604/282.
4611785	Sep., 1986	Steer	251/4.
4613329	Sep., 1986	Bodicky	604/158.
4626245	Dec., 1986	Weinstein	604/167.
4629450	Dec., 1986	Suzuki et al.	604/164.
4634432	Jan., 1987	Kocak	604/167.
4654030	Mar., 1987	Moll et al.	604/165.
4655752	Apr., 1987	Honkanen et al.	604/256.
4664660	May., 1987	Goldberg et al.	604/321.
4668221	May., 1987	Luther	604/164.
4670008	Jun., 1987	Von Albertini	604/165.
4673393	Jun., 1987	Suzuki et al.	604/167.
4705511	Nov., 1987	Kocak	604/282.
4723550	Feb., 1988	Bales et al.	604/256.
4729914	Mar., 1988	Kliment et al.	428/36.
4735614	Apr., 1988	Yapp et al.	604/165.
4758225	Jul., 1988	Cox et al.	604/126.
4769005	Sep., 1988	Ginsburg et al.	604/53.
4772264	Sep., 1988	Cragg	604/158.
4790817	Dec., 1988	Luther	604/53.
4808168	Feb., 1989	Warring	604/158.
4817631	Apr., 1989	Schnepp-Pesch et al.	128/753.
4842591	Jun., 1989	Luther	604/283.
4857062	Aug., 1989	Russell	604/256.
4862891	Sep., 1989	Smith	604/104.
4869717	Sep., 1989	Adair	604/51.
4874378	Oct., 1989	Hillstead	604/167.
4899729	Feb., 1990	Gill et al.	128/3.
4902280	Feb., 1990	Lander	604/165.
4909798	Mar., 1990	Fleischhacker et al.	604/256.
4917668	Apr., 1990	Haindl	604/167.
4919653	Apr., 1990	Martinez et al.	604/117.
4929235	May., 1990	Merry et al.	604/167.
4931042	Jun., 1990	Holmes et al.	604/164.
4932633	Jun., 1990	Johnson et al.	604/256.
4935008	Jun., 1990	Lewis, Jr.	604/52.
4943280	Jul., 1990	Lander	604/169.
4950257	Aug., 1990	Hibbs et al.	604/265.
4954130	Sep., 1990	Edwards	604/169.
4960412	Oct., 1990	Fink	604/167.
4966588	Oct., 1990	Rayman et al.	604/165.
4978334	Dec., 1990	Toye et al.	604/51.
4978341	Dec., 1990	Niederhauser	604/167.
4981482	Jan., 1991	Ichikawa	606/108.
4994027	Feb., 1991	Farrell	604/53.
5000745	Mar., 1991	Guest et al.	604/256.
5002557	Mar., 1991	Hasson	606/191.
5009643	Apr., 1991	Reich et al.	604/165.
5015239	May., 1991	Browne	604/166.
5030206	Jul., 1991	Lander	604/164.
5038756	Aug., 1991	Kepley	604/22.
5041095	Aug., 1991	Littrell	604/167.
5041097	Aug., 1991	Johnson	604/167.
5053014	Oct., 1991	Van Heugten	604/167.
5053016	Oct., 1991	Lander	604/169.
5059186	Oct., 1991	Yamamoto et al.	604/280.
5066288	Nov., 1991	Deniega et al.	604/274.
5073169	Dec., 1991	Raiken	604/180.
5092846	Mar., 1992	Nishijima et al.	604/165.
5104383	Apr., 1992	Shichman	604/167.
5104389	Apr., 1992	Deem et al.	604/264.
5108380	Apr., 1992	Herlitze et al.	604/283.
5112308	May., 1992	Olsen et al.	604/164.
5112321	May., 1992	Hiltebrandt	604/264.
5114407	May., 1992	Burbank	604/164.
5116353	May., 1992	Green	604/184.
5122122	Jun., 1992	Allgood	604/174.
5127626	Jul., 1992	Hilal et al.	251/149.
5127909	Jul., 1992	Shichman	604/165.
5129885	Jul., 1992	Green et al.	604/164.
5137520	Aug., 1992	Maxson et al.	604/180.
5139511	Aug., 1992	Gill et al.	604/198.
5141498	Aug., 1992	Christian	604/167.
5158553	Oct., 1992	Berry et al.	604/248.
5161773	Nov., 1992	Tower	251/5.
5167636	Dec., 1992	Clement	604/167.
5171231	Dec., 1992	Heileger	604/263.
5176648	Jan., 1993	Holmes et al.	604/164.
5176651	Jan., 1993	Allgood et al.	604/167.
5176659	Jan., 1993	Mancini	604/280.
5176697	Jan., 1993	Hasson et al.	604/191.
5180373	Jan., 1993	Green et al.	604/167.
5183464	Feb., 1993	Dubrul et al.	128/3.
5188605	Feb., 1993	Sleep	604/158.
5188607	Feb., 1993	Wu	604/167.
5197955	Mar., 1993	Stephens et al.	604/167.
5201714	Apr., 1993	Gentelia et al.	604/167.
5207656	May., 1993	Kranys	604/256.
5209736	May., 1993	Stephens et al.	604/164.
5209737	May., 1993	Ritchart et al.	604/167.
5211370	May., 1993	Powers	251/4.
5211633	May., 1993	Stouder, Jr.	604/167.
5221264	Jun., 1993	Wilk et al.	604/167.
5226891	Jul., 1993	Bushatz et al.	604/165.
5242412	Sep., 1993	Blake, III	604/167.
5256150	Oct., 1993	Quiachon et al.	604/171.
5300036	Apr., 1994	Mueller et al.	604/167.
5304143	Apr., 1994	Green et al.	604/167.
5308336	May., 1994	Hart et al.	604/167.
5312363	May., 1994	Ryan et al.	604/167.
5330437	Jul., 1994	Durman	604/167.
5334164	Aug., 1994	Guy et al.	604/248.
5342315	Aug., 1994	Rowe et al.	604/167.
5350364	Sep., 1994	Stephens et al.	604/167.
5350393	Sep., 1994	Yoon	606/185.
5360417	Nov., 1994	Gravener et al.	604/169.
5366446	Nov., 1994	Tal et al.	604/110.
5380288	Jan., 1995	Hart et al.	604/167.
5385553	Jan., 1995	Hart et al.	604/167.
5389080	Feb., 1995	Yoon	604/167.
5389081	Feb., 1995	Castro	604/167.
5391153	Feb., 1995	Haber et al.	604/167.
5391154	Feb., 1995	Young	604/167.
5395342	Mar., 1995	Yoon	604/167.
5401248	Mar., 1995	Bencini	604/167.
5411483	May., 1995	Loomas et al.	604/167.
5429609	Jul., 1995	Yoon	604/167.
5441486	Aug., 1995	Yoon	604/167.
5460616	Oct., 1995	Weinstein et al.	604/167.
5476475	Dec., 1995	Gadberry	606/185.
5478318	Dec., 1995	Yoon	604/167.
Foreign Patent Documents
0051718	May., 1982	EP.
0113520	Jul., 1984	EP.
0206553	Dec., 1986	EP.
0223451	May., 1987	EP.
0267584	May., 1988	EP.
0312219	Apr., 1989	EP.
0316096	May., 1989	EP.
0336903	Oct., 1989	EP.
0349955	Jan., 1990	EP.
0350291	Jan., 1990	EP.
0426407	May., 1991	EP.
0510851	Oct., 1992	EP.
3042229	May., 1982	DE.
3737121	May., 1989	DE.
4020956	Jan., 1991	DE.
1024410	Mar., 1966	GB.
9404717	Mar., 1993	WO.

Primary Examiner: O'Connor; Cary E.

Parent Case Text

This application is a continuation of prior application Ser. No. 07/557,869, filed Jul. 26, 1990, now U.S. Pat. No. 5,395,342.

Claims

What is claimed is:

1. A seal assembly for use with an endoscopic portal to engage surgical instruments of various sizes passing therethrough in sealing relation comprising

a member having a central opening therein;

a plurality of legs disposed around said opening and being spreadable outwardly from an inwardly extending position when a surgical instrument is passed through said seal assembly, said legs being made of non-elastomeric material; and

a stretchable membrane disposed over said legs, said membrane stretching when said legs spread outwardly from said inwardly extending position and said membrane having a hole therein for sealing engagement with a surgical instrument passed through said seal assembly.

2. A seal assembly as recited in claim 1, wherein said legs create spaces therebetween when said legs spread outwardly and said membrane covers said spaces.

3. A seal assembly as recited in claim 1, wherein said legs are concentrically disposed around said opening slightly spaced from each other to define gaps therebetween and said membrane extends to said member to cover said gaps.

4. A seal assembly as recited in claim 1, wherein said legs extend distally from said member to produce a conical configuration and said membrane includes a conical sleeve having a configuration to fit over said legs.

5. A seal assembly for use with an endoscopic portal to engage surgical instruments of various sizes passing therethrough in sealing relation comprising

a housing having a passage therethrough;

a stretchable membrane disposed over said passage to tightly engage a surgical instrument passing through said housing; and

a plurality of spaced legs of nylon-like material disposed in said housing proximally of said membrane to be contacted by a surgical instrument passing through said housing and to flex outwardly stretching said membrane.

6. A seal assembly as recited in claim 5, wherein said membrane has a conical configuration with a distally disposed apex and a hole in said apex for tightly engaging a surgical instrument passing through said housing at a position distally of said legs.

7. A seal assembly for use with an endoscopic portal to engage surgical instruments of various sizes passing therethrough in sealing relation comprising

a member having a central opening therein;

a plurality of legs disposed around said opening and being spreadable outwardly from an inwardly extending position when a surgical instrument is passed through said opening, said legs being made of a material facilitating movement of a surgical instrument therethrough; and

a stretchable membrane disposed tightly over said legs, said membrane stretching when said legs are spread outwardly from said inwardly extending position and said membrane having a hole therein for sealing engagement with a surgical instrument passed through said opening.

8. A seal assembly for use with an endoscopic portal to engage surgical instruments of various sizes passing therethrough in sealing relation comprising

a member having a central opening therein;

a plurality of legs disposed around said opening and being spreadable outwardly from an inwardly extending position when a surgical instrument in passed through said opening, said legs being made of a material facilitating movement of a surgical instrument therethrough; and

a stretchable membrane disposed over said legs in a manner biasing said legs to said inwardly extending position, said membrane stretching when said legs are spread outwardly from said inwardly extending position and said membrane having a hole therein for sealing engagement with a surgical instrument passed through said opening.

Description

FIELD OF THE INVENTION

The present invention pertains to endoscopic surgical instruments and, more particularly, to a valve assembly for providing a variable size passage in an endoscopic portal to prevent fluid flow through the valve while allowing surgical implements of various sizes to be selectively introduced through the valve.

DESCRIPTION OF THE PRIOR ART

Surgical procedures involving the placement of an endoscopic portal, such as a sleeve or cannula, through a body wall to provide a passage for insertion of surgical instruments frequently require that the passage be sealed to prevent the flow of fluids through the endoscopic portal. For example, many medical procedures gain access to the interior of an anatomical cavity by utilizing a surgical puncturing or penetrating instrument, such as a trocar, obturator or needle, having a sharp penetrating point for puncturing or penetrating the cavity wall to establish communication with the interior of the anatomical cavity. A sleeve or cannula is then left in situ for utilization as a portal to introduce surgical instruments into the anatomical cavity. Because it is necessary to prevent fluid flow to and from the surgical site, the portal must be sealed prior to and subsequent to the introduction of surgical instruments and while such instruments are in place. Furthermore, fluids, such as gaseous phase carbon dioxide or nitrous oxide, may be introduced into the anatomical cavity for insufflation as part of the surgical procedure, and the escape of the gas must be prevented during puncturing and during the endoscopic surgical procedure. Typically, surgical instruments are inserted into the portal via a valve that has a single, particular size passage dependent upon the puncturing instrument. However, additional instruments to be introduced into the anatomical cavity through the passage, may be of diverse types and sizes, and it will be appreciated that fluid can escape past smaller instruments.

A surgical puncturing instrument is usually received within a portal sleeve that passes through the wall of an anatomical cavity with the puncturing instrument and remains in place to establish communication with the interior of the cavity after the puncturing instrument has been removed from the sleeve. The sleeve typically has a proximal end secured in a housing provided with a valve that allows the puncturing instrument to be inserted into the sleeve. The valve prevents the flow of fluids to and from the anatomical cavity and closes when the puncturing instrument is removed from the sleeve. The size of the puncturing instrument utilized varies depending upon the surgical procedure and the type of anatomical cavity to be punctured. Once the puncturing instrument has been removed from the sleeve, a great variety of instruments of various sizes and diameters are introduced into the anatomical cavity via the portal dependent upon the procedure to be performed.

Prior art endoscopic portals utilize a valve, such as a flapper or gate valve, that is normally biased to a closed position but in an open position has a passage or lumen therethrough of only a single size. Accordingly, such endoscopic portals suffer from the disadvantages of allowing the passage or leakage of fluids when surgical instruments smaller than the single passage are introduced therethrough or of limiting the implements to be used in a procedure to a single size. Additionally, such endoscopic portals can be effectively used with only a single size puncturing instrument.

SUMMARY OF THE INVENTION

Accordingly, it is a primary object of the present invention to overcome the above described disadvantages of the prior art by utilizing a valve assembly in an endoscopic portal that provides a variable size passage therethrough to engage surgical instruments of various sizes in sealing relation.

Another object of the present invention is to provide an endoscopic portal with a valve having multiple lumens or passages of diverse sizes for selection to produce a sealing relation with surgical instruments of various sizes.

A further object of the present invention is to provide a valve assembly for an endoscopic portal that normally seals an opening or passage therethrough and allows surgical instruments of diverse sizes to be introduced through the opening or passage while preventing fluid flow or leakage.

The present invention has another object in the use of an elastic or stretchable sleeve in combination with a plurality of spreadable legs to produce a valve for an endoscopic portal having a variable size passage therethrough.

Some of the advantages of the present invention over the prior art are that a complete endoscopic procedure can be performed with a single portal thereby reducing instrument costs and surgery time, a single endoscopic portal can be used with various sizes and types of puncturing instruments, and the endoscopic portal can be inexpensively manufactured to be economically disposable for single patient use.

The present invention is generally characterized in a endoscopic portal including a sleeve or cannula having an open proximal end to provide access to an internal operative site and a valve assembly disposed at the open proximal end of the sleeve for controlling fluid passing therethrough and including a passage of variable size for engaging surgical instruments of various sizes in sealing relation. In one embodiment, the valve assembly includes a plurality of different size lumens or passages that can be selectively aligned with the open proximal end of the sleeve. In another embodiment, the valve assembly stretches or elastically expands to accommodate various size surgical instruments.

Other objects and advantages of the present invention will become apparent from the flowing description of the preferred embodiment taken in conjunction with the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a side view, partly in section, of an endoscopic portal according to the present invention.

FIG. 2 is a section taken along line 2--2 of FIG. 1.

FIG. 3 is a broken view taken along line 3--3 of FIG. 2.

FIG. 4 is a broken side view of the endoscopic portal of FIG. 1.

FIG. 5 is a exploded, perspective view of another valve assembly for the endoscopic portal of the present invention.

FIG. 6 is a broken side view, partly in section, of the valve assembly of FIG. 5 with a surgical instrument passing therethrough.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

With reference to FIG. 1, an endoscopic portal 10 including a valve assembly 12 according to the present invention is shown in combination with a surgical puncturing or penetrating instrument 14 for puncturing the wall of an anatomical cavity. The puncturing instrument 14 is illustrated as a hollow or tubular needle having an angled, sharp distal end 16; however, any type of puncturing instrument can be utilized in combination with the endoscopic portal 10, such as solid trocars or obturators. The puncturing instrument 14 has a proximal end 18 defining an enlarged handle to allow the puncturing instrument to be withdrawn after insertion.

The endoscopic portal 10 includes a tubular, cylindrical sleeve or cannula 20 for positioning through the body wall during the puncturing procedure to provide access to an internal operative site. The sleeve 20 has a tapered, open distal end 22 adapted to be disposed within the body and an open, proximal end 24 adapted to be disposed externally of the body. The proximal end 24 is externally threaded to engage internal threads at the forward end of a housing 26 to couple the housing with the proximal end of the sleeve. Housing 26 has an enlarged forward flange 28 joined to a tubular end 30 that is internally threaded for receiving the proximal end 24 of sleeve 20. Housing 26 has a generally cylindrical wall 32 extending from flange 28 and terminating at an open, internally threaded end 34, and a valve block 36 is received in end 34. Block 36 has an enlarged flange 38 extending therefrom and an external thread for engaging the internal thread at open end 34 to secure block 36 in the housing. Block 36 is closely received within wall 32 and terminates in a tapered wall 40 positioned adjacent end 30.

A longitudinal passage 42 is defined through the housing including an opening in flange 38 and a bore through block 36 in longitudinal alignment with the longitudinal axis of sleeve 20, and implements such as puncturing instruments 14 can be inserted into sleeve 20 via passage 42. A cylindrical recess 44 is formed in block 36 on an axis transverse to passage 42, and a cylindrical valve body 46 is disposed in recess 44 to be rotatable about its central longitudinal axis which intersects and is oriented transverse to the longitudinal axis of passage 42.

A plurality of different size passages or lumens 48, 50 and 52 are formed in valve body 46 radially with respect to the central longitudinal axis of the valve body. Lumens 48, 50 and 52 have longitudinal axes contained in a common plane, as shown in FIG. 2, which also contains the longitudinal axis of passage 42. Lumens 48, 50 and 52 are angularly spaced from each other and the angular spacing is selected to provide opposing solid surfaces 54 and 46 on opposite sides of valve body 46 defining arcs of the cylinder large enough in size to cover and seal passage 42 when the solid surfaces 54 and 56 are aligned with passage 42 by rotation of the valve body. Lumens 48, 50 and 52 are of different size or diameter; and, as shown in FIGS. 1 and 2, lumen 50 is the largest diameter passage, lumen 52 is the next largest diameter passage and lumen 48 is the smallest diameter passage.

As depicted in FIGS. 2 and 3, a lower end 58 of valve body 46 has a shaft 60 extending therefrom in longitudinal alignment with the central longitudinal axis of the valve body to project through an opening in a bottom wall 62 of block 36 and terminates at an end surface 64. A slot 66 is formed in end surface 64 to receive one end of a coil spring 68 disposed around shaft 60. A pin 70 projects perpendicularly from wall 62, and the other end of spring 68 abuts pin 70. Spring 68 is rotationally biased to normally maintain valve body 46 in a closed position wherein solid surfaces 54 and 56 on the valve body are aligned with passage 42 to close off the passage and seal the housing 26. The upper end 72 of the valve body is fixed to a cover 74 disposed above housing 26, and an elongated ridge 76 projects from cover 74. In the normally closed portion, ridge 76 is oriented transverse to passage 42 as shown in phantom in FIG. 4. Ridge 76 can be manually grasped and rotated in a counter-clockwise direction, looking at FIG. 4, to rotate valve body 46 to an open position corresponding to one of the lumens 48, 50 or 52 being aligned with passage 42 and the open proximal end 24 of sleeve 20. Thus, the first rotational position for valve body 46 aligns lumen 48 with passage 42, the second rotational position for valve body 46 aligns lumen 50 with passage 42, and the third rotational position for valve body 46 aligns lumen 52 with passage 42. Indicia 78 can be provided on the housing 26 to indicate open positions for valve 48 when the ridge 76 is radially aligned with such indicia.

While it is preferred to bias the valve assembly to a normally closed position, bias spring 68 is not required, and the valve body can be held in any of its open positions or its closed position with the use of suitable detents. For example, spring biased ball bearings 80 can be disposed in the block 36 and corresponding recesses 82 can be formed in the valve body 46, or vice versa, as shown in phantom in FIG. 2.

In operation, spring 68 rotationally biases valve body 46 to the closed position where solid surfaces 54 and 56 on the valve body are aligned with passage 42 to seal the housing. Valve body 46 may be rotated by grasping and turning ridge 70 to align the central longitudinal axis of a selected one of the lumens 48, 50 or 52 with the longitudinal axis of passage 42, and an implement such as puncturing instrument 14 having a size corresponding to the size of the aligned lumen can be inserted into the opening in flange 38 to extend through the aligned lumen of the valve body and sleeve 20. Since the aligned lumen corresponds to the size of the inserted implement and the valve body 46 is sealingly received in block 36, the passage of fluids through the housing and valve assembly are prevented. The valve assembly therefore, permits diverse surgical instruments to be inserted into the sleeve with a single portal in a manner maintaining a sealed environment.

When utilized in conjunction with puncturing instrument 14, valve body 46 is rotated to align lumen 50 in valve body 46 with passage 42 in block 36, lumen 50 corresponding in size and cross-sectional shape with puncturing instrument 14 to provide sealing engagement therebetween. The distal end 16 of puncturing instrument 14 is inserted into the housing 26 through the opening in flange 38 to extend through passage 42, lumen 50 and sleeve 20 such that distal end 16 projects from the distal end 22 of the sleeve. For laparoscopy, in many cases, a pneumoperitoneum will have been created, for example with the use of a Varres needle. When the puncturing instrument is forced through the anatomical wall, escape of gas from the peritoneum will be prevented due to the seal between the puncturing instrument and the valve assembly. When the puncturing instrument is hollow, such as the illustrated needle, the distal end 18 will be closed to prevent passage of fluid therethrough. If no pneumoperitoneum has been created prior to insertion of the puncturing instrument, insufflation can be accomplished via a valve, not shown, in the proximal end 18 of the needle. Once the anatomical cavity is insufflated and the endoscopic surgical instrument is in place with sleeve 20 passing through the anatomical wall, the puncturing instrument is removed whereupon the spring 68 automatically restores the valve body to the closed position to prevent gas from escaping. Valve body 46 can now be rotated to align the same or a different lumen with passage 42 to allow the same or a different sized surgical instrument to be inserted therethrough for introduction via the sleeve to the operative site.

The number of different size lumens or passages in the valve assembly and the sizes thereof are dependent upon the instruments to be used in the endoscopic procedure to be performed. For example, frequently used instruments commonly have diameters of 3 mm, 5 mm, 7 mm, 10 mm and 12 mm; and, thus, lumens corresponding to these diameters are preferred. By use of indicia 78 on the housing wall 32 in combination with ridge 76, which can act as a pointer or indicator, accurate alignment of a desired lumen can be achieved. By use of detents 80, 82, the accurate alignment of the lumen or passage through the valve assembly with the housing and sleeve can further be assured.

Another embodiment of a valve assembly providing variable passage sizes therethrough in accordance with the present invention is illustrated in FIGS. 5 and 6 and includes a member 84 having a flange 86 adapted to be sealingly mounted in housing 26, for example by providing external threads on the peripheral edge of the flange. A plurality of spaced, spreadable legs 88 extend distally from flange 86 to produce a normally conical configuration tapering to an apex as shown in FIG. 5. The legs 88 and flange 86 are preferably integrally made of unitary construction of a material facilitating movement of medical instruments therethrough and allowing legs 88 to flex, such as a plastic like nylon. The legs 88 are concentrically disposed around a central opening 90 in flange 86 and are slightly spaced from each other as shown by gaps 92 which terminate at curved relief recesses 94. A conical, stretchable sleeve or membrane 96, preferably made of a rubber-like material such as silicone, has a configuration to tightly fit over legs 88 such that the sleeve and legs are normally biased to a closed position at the apex to prevent passage of fluids through the valve assembly.

In use, the valve assembly is normally biased to a closed position due to the elastic force of conical sleeve 96 around legs 88; and, when a surgical instrument 98 is inserted through housing 26 and sleeve 20, the surgical instrument 98 will pass through opening 90 and cause legs 88 to flex outwardly stretching conical sleeve 96 to the position shown in FIG. 6. The conical sleeve acts as a seal to prevent passage of fluids thereby and tightly engages the surgical instrument in the gaps 92 where the legs 88 are spread apart. The valve assembly provides a passage of variable size to accommodate surgical instruments of various sizes passing therethrough in that legs 88 and conical sleeve 96 contract to sealingly engage the surgical instrument regardless of the diameter thereof.

Inasmuch as the present invention is subject to many modifications, variations and changes in detail, it is intended that all subject matter discussed above or shown in the illustrative drawings be interpreted as illustrative only and not to be taken in a limiting sense.

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Current U.S. Class:	604/167.01; 604/248
Intern'l Class:	A61B 017/32; A61B 019/00
Field of Search:	604/158,159,160,161,162,163,164,165,166,167,168,169,170,248,264